Gliederung

Objective: To evaluate midterm clinical and angiographic results after using a self-expanding neurovascular stent and coils in the management of broad-based intracranial aneurysms.

Methods: During a period from August 2001 to October 2004 we treated a total of 42 patients with 44 aneurysms using a self-expandable stent. Up to now we have more than 6 months of follow-up in 25 patients with 26 aneurysms. Aneurysm occlusion was divided into the following categories: 100% (complete), 95-99% (subtotal), and <95% (incomplete).

Results: In 15 aneurysms complete occlusion was initially achieved, in 11 aneurysms subtotal occlusion. Control DSA showed progressive thrombosis in seven aneurysms leading to total occlusion in another 4 aneurysms. Three recanalizations were observed in one large and two giant ICA aneurysms. No vessel occlusion occurred. One vessel stenosis of the stented segment was noted but it was not clinically relevant. One patient experienced a small embolic infarction after stopping antiplatelet medication. No persistent deterioration of the clinical status was seen.

Conclusions: Combining a stent with coils seems to be an acceptable treatment option in broad-based intracranial aneurysms. Considering that this special subgroup of treated aneurysms includes only those with an unfavourable geometry, these results are extremely promising.